Objective  To observe the effect of tripterygium glycosides combined with alprostadil in the treatment of patients with diabetic nephropathy (DN).

  Methods   Totally 115 patients with DN were divided into three groups. All the patients received routine treatment, the control group A (n=36) was treated with alprostadil, the control group B (n=38) was treated with tripterygium glycosides, and the combined group (n=41) was treated with tripterygium glycosides and alprostadil. After 3 months of treatment, the clinical efficacy, renal function indexes 24 h urinary protein quantification, urinary albumin excretion rate (UAER) and creatinine clearance rate (Ccr), immune imbalance cell ratios of regulatory T cell (Treg) and helper T cell 17 (Th17) and ratio of Th17 to Treg (Th17/Treg), inflammatory mediators high mobility group protein B1 (HMGB1), cell adhesion molecule-1 (ICAM-1) and transforming growth factor β₁ (TGF-β₁) and adverse reactions were compared among the three groups.

  Results  After 3 months of treatment, UAER, 24 h urinary protein quantification, Th17 cell ratio, Th17/Treg, serum ICAM-1, TGF-β and HMGB1 in the combined group were significantly lower than those in the control groups A and B, while the Ccr, Treg cell ratio and objective remission rate were significantly higher than those in control groups A and B (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0.05).

  Conclusion   Tripterygium glycosides combined with alprostadil is safe and effective in the treatment of DN, which can alleviate inflammatory reaction, correct immune imbalance and improve renal function.